Individual
TANESHA DENISE BUTLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3315 WARWICK DR, SHREVEPORT, LA 71118-4323
(318) 655-0840
Mailing address
3315 WARWICK DR, SHREVEPORT, LA 71118-4323
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
9089
LA
Other
Enumeration date
08/16/2018
Last updated
08/16/2018
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